Acne Treatment in South Africa: Symptoms, Causes and When to See a Specialist

Acne vulgaris is one of the most common skin conditions worldwide, affecting up to 85% of people at some point between adolescence and adulthood. In South Africa, acne is a frequent reason for visits to general practitioners and dermatologists, and it can have a significant impact on self-esteem and quality of life. This article explains what causes acne, how to recognise it, and what treatment options are available locally.

What Is Acne?

Acne is a chronic inflammatory condition of the hair follicles and oil (sebaceous) glands in the skin. It most commonly affects the face, chest, back and shoulders, where oil glands are most active.

Common Symptoms

• Blackheads and whiteheads (comedones)
• Red, inflamed pimples (papules and pustules)
• Painful, deep nodules or cysts in more severe cases
• Oily skin
• Scarring or dark marks (post-inflammatory hyperpigmentation), which can be more pronounced in darker skin tones common among South Africans

What Causes Acne?

According to the American Academy of Dermatology and peer-reviewed research, acne develops due to a combination of factors:

1. Excess sebum (oil) production – often driven by hormonal changes, especially during puberty. 2. Blocked hair follicles – dead skin cells clog pores, trapping oil and bacteria. 3. Bacterial overgrowth – Cutibacterium acnes bacteria thrive in blocked follicles, triggering inflammation. 4. Inflammation – the body's immune response causes redness and swelling. 5. Hormonal fluctuations – puberty, menstrual cycles, polycystic ovary syndrome (PCOS), and certain medications can worsen acne. 6. Genetics – a family history of acne increases risk.

Contrary to popular belief, diet and hygiene are not primary causes of acne, although some studies suggest high-glycaemic diets and dairy may worsen it in some individuals.

How Is Acne Diagnosed?

Acne is usually diagnosed clinically by a general practitioner or dermatologist based on the appearance and distribution of lesions. In cases where hormonal imbalance is suspected (for example, in women with irregular periods, excess hair growth, or weight gain), blood tests may be recommended to check for conditions like PCOS.

Treatment Options Available in South Africa

Treatment depends on the severity of acne and should ideally be guided by a healthcare professional. Options recognised by NICE (UK National Institute for Health and Care Excellence) and the South African Dermatology Society include:

Mild Acne

• Topical retinoids (e.g. adapalene)
• Benzoyl peroxide
• Topical antibiotics combined with benzoyl peroxide to reduce antibiotic resistance

Moderate Acne

• Combination topical therapy
• Oral antibiotics (such as doxycycline) for a limited period, alongside topical treatment
• Hormonal treatments, such as combined oral contraceptives, for women where appropriate

Severe or Cystic Acne

• Oral isotretinoin, prescribed and monitored by a dermatologist due to potential side effects and the need for pregnancy prevention counselling in women
• Referral to a dermatologist for specialised management

Supportive Skincare

• Gentle, non-comedogenic cleansers
• Daily broad-spectrum sunscreen, particularly important given South Africa's high UV exposure
• Avoiding picking or squeezing lesions to reduce scarring risk

When to See an Acne Specialist

You should consider consulting a dermatologist if:

• Over-the-counter treatments have not improved your acne after 6–8 weeks
• You have painful nodules or cysts
• You are developing scarring or significant pigmentation changes
• Acne is affecting your emotional wellbeing or self-confidence
• You suspect an underlying hormonal cause

Dermatologists in South Africa can offer prescription-strength treatments, in-office procedures (such as chemical peels or light-based therapies), and long-term management plans tailored to your skin type.

Finding Acne Treatment in South Africa

Many South Africans start with a GP, who can prescribe first-line treatments and refer patients to a dermatologist when needed. Public healthcare facilities and private dermatology practices across major cities such as Johannesburg, Cape Town, Durban and Pretoria offer acne management services. The Getadoc directory can help you find a qualified dermatologist or GP near you.

Frequently Asked Questions

Is acne only a teenage problem? No. While acne commonly starts in adolescence, adult acne is increasingly recognised, particularly in women, and can persist into the 30s and 40s due to hormonal factors.

Can diet cause acne? Diet is not a primary cause, but some studies suggest that high-glycaemic-index foods and dairy products may worsen acne in some people. Speak to your healthcare provider before making major dietary changes for acne control.

Is it safe to use benzoyl peroxide and retinoids together? Yes, when used correctly, but it's best to introduce them gradually and follow guidance from a healthcare professional to reduce skin irritation.

How long does acne treatment take to work? Most topical treatments take 6–8 weeks to show noticeable improvement, and full benefit may take 3–4 months. Consistency is key.

Does acne leave permanent scars? It can, especially if lesions are picked or squeezed, or if severe cystic acne is left untreated. Early, appropriate treatment reduces the risk of scarring.

This article is for general informational purposes only and does not replace personalised medical advice. Please consult a qualified healthcare professional for diagnosis and treatment tailored to your individual needs.